Kathy Wilson arranges angels on the marker at the cemetery in Andrews, NC. She had to pay to have her husband Jim's body exhumed because the medical examiner made the wrong ruling in his death. An autopsy showed James Wilson died of injuries sustained in a car wreck -- not of a heart attack. The distinction was important because his insurance policies didn't pay in case of a natural death. Her daughter Jenny is also buried in this spot, she passed away months after her step father. JEFF WILLHELM - jwillhelm@charlotteobserver.com JEFF WILLHELMjwillhelm@charlotteobserver.com

Kathy Wilson arranges angels on the marker at the cemetery in Andrews, NC. She had to pay to have her husband Jim's body exhumed because the medical examiner made the wrong ruling in his death. An autopsy showed James Wilson died of injuries sustained in a car wreck -- not of a heart attack. The distinction was important because his insurance policies didn't pay in case of a natural death. Her daughter Jenny is also buried in this spot, she passed away months after her step father. JEFF WILLHELM - jwillhelm@charlotteobserver.com JEFF WILLHELMjwillhelm@charlotteobserver.com

Medical examiner botched wreck case ruling

The N.C. Industrial Commission has ruled that a widow deserves damages because a state medical examiner did not take basic steps to find out how her husband died and wrongly declared that he suffered a heart attack.

In a written opinion, Deputy Commissioner Stephen Gheen said that Cathy Wilson was initially denied life insurance payouts after a fatal 2011 auto wreck when the medical examiner failed to thoroughly inspect her husband’s body or order an autopsy.

If it stands, the February ruling may allow other families to win damages when the state’s troubled medical examiner system produces inaccurate cause-of-death rulings.

“Mrs. Wilson was a grieving widow who needlessly suffered additional anguish,” Gheen said. “(Her) anxiety over the denial of insurance benefits was real and understandable.” He added that stress from the ordeal left her unable to eat or sleep.

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But Wilson won’t reap a large financial windfall. Gheen awarded her roughly $63,500 – about the same amount she paid to attorneys and to exhume her husband’s body.

“It doesn’t make me real happy, but there’s nothing I can do about it,” said Wilson, who lived with her late husband, Jim, in Cherokee County, about 200 miles west of Charlotte.

Wilson told the Observer last summer that she was shattered by the accident and losing her husband. But Gheen wrote that he could not provide Wilson damages for emotional distress because there is no evidence she sought medical or psychiatric treatment for depression, anxiety or another condition.

Wilson, in fact, may never see the award. Kevin Howell, a spokesman for the N.C. Department of Health and Human Services, which oversees the state medical examiner’s office, said in an email the agency will appeal the ruling.

That means a three-member panel from the Industrial Commission will decide whether Wilson gets to collect the money she was awarded, and that process could take months.

Medical examiners – typically doctors and nurses who look into deaths in their off hours – are supposed to determine the cause of suspicious and violent deaths, such as shootings, suicides, auto wrecks and drownings. Their work is used to solve crimes, identify public health trends and settle life insurance payouts.

N.C. Chief Medical Examiner Dr. Deborah Radisch and other state officials have argued that while the initial death ruling in the Wilson case was wrong, it was not unreasonable for the medical examiner to conclude he died from a heart attack.

They testified that it is common for drivers to suffer heart attacks before crashing their vehicles. Jim Wilson, who was 60, had health problems, including a heart condition, according to court records.

‘Incomplete investigation’

On a rainy morning on March 9, 2011, Jim Wilson was driving his pickup up a steep hill when something caused the truck to run off the road, hit a tree and turn over on its side.

In his report, Highway Patrol Trooper J. Cochran wrote that “due to a medical condition (Wilson) was unable to maintain control.”

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“We called the medical examiner and … I told her what happened,” Cochran said. “The only thing he had was some bruising in his upper chest.”

Jane Barwick, a nurse practitioner who is a medical examiner in Cherokee County, investigated the case. But Barwick did not go to the scene or order an autopsy despite guidelines requiring the exam when there is a reasonable suspicion that trauma from an external force caused the death.

Her report incorrectly notes that Jim Wilson was wearing a seat belt. Court records conclude he was not.

Barwick examined Wilson’s body at a hospital and found bruising on his abdomen and a laceration of his left eyelid, but concluded his death was due to ischemic heart disease, chronic obstructive pulmonary disease and diabetes.

He said she failed to question law enforcement and EMS about the severity of the collision, which was so strong the truck’s steering wheel broke apart and injured Wilson.

Gheen also said that Barwick did not obtain updated information about Wilson or interview medical providers and family members, a basic part of any suspicious death investigation.

“Barwick’s conclusions were based on an incomplete investigation in which she chose not to investigate other reasonable explanations for the cause of death despite clear indications that Mr. Wilson’s body had sustained trauma,” Gheen wrote.

Barwick did not return phone calls seeking comment.

Financial consequences

The difference between her husband’s death from a heart attack, as opposed to injuries from an auto crash, was huge for Cathy Wilson.

Two life insurance policies paid only if his death resulted from an accident, and a third policy paid more if his death was accidental.

Cathy Wilson had the body exhumed and sent to Raleigh for an autopsy. She then paid to have her husband’s body brought back to Andrews and reburied.

Chief Medical Examiner Radisch’s autopsy showed that Jim Wilson died from injuries suffered in the wreck. With a new cause of death, three insurance companies paid benefits to Wilson, which she said totaled about $300,000.

Nearly four years later, she is attempting to recoup money she spent during the legal fight and to hold the state accountable for her emotional suffering. She was seeking $250,000.

Cathy Wilson said she did not understand why she was not awarded more money. She said she and her attorney were not given an explanation.

Legal experts say victims of negligence typically must obtain a diagnosis from a doctor for the court to award compensation for emotional distress. Some attorneys advise clients to go to a doctor immediately.

“It’s like nice guys finish last,” said John Kirby, a Raleigh attorney who specializes in tort claim litigation.

A flawed system

Gheen’s ruling is significant because North Carolina’s medical examiner system is prone to mistakes.

An Observer series published last year found that the state’s 350 examiners often don’t adhere to recommended practices, raising questions about the accuracy of their rulings.

In most cases, they don’t go to death scenes and sometimes don’t view bodies. The state doesn’t require training for examiners and rarely disciplines them for violating rules.

Bob Bollinger, a Charlotte attorney, said the case points to a larger problem. Unlike states and counties with leading examiner systems, North Carolina relies on volunteers paid $100 per case instead of trained professionals.

“Maybe if you paid $400 per case, you would get different results,” he said. “This could have all been avoided if the medical examiner had followed the rules.”

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Examiners’ mistakes spur legal action

At least three other families have filed lawsuits alleging that mistakes by medical examiners caused them emotional, mental and physical duress. The N.C. Industrial Commission and attorneys believe the cases are among the first in state history where survivors are seeking damages for the handling of suspicious deaths.

▪ In May 2014, the commission awarded nearly $400,000 to the family of Lorraine Young because a Guilford County medical examiner misidentified her corpse and sent it to the wrong funeral home.

The ruling determined that medical examiners have an obligation to try to correctly identify the deceased in their cases.

▪ In June 2014, the N.C. Court of Appeals ruled unanimously that Gretchen Crowder of Charlotte cannot sue the state for damages because a Gaston County medical examiner conducted a flawed investigation into her son’s death.

The three-judge panel said the N.C. Department of Health and Human Services is protected from liability because medical examiners work for the public and have no duty to individual families.

▪ In January, North Carolina officials agreed to pay $425,000 to Larry Green, who was mistakenly declared dead by a Franklin County medical examiner, zipped into a body bag and sent to a morgue.

The payment settled a lawsuit that alleged the medical examiner’s mistake left Green paralyzed and suffering from severe brain damage.